East Midlands pioneered ADHD technology recommended in new NICE guidance

The guidance, published during ADHD Awareness Month, coincides with the news that one million patients worldwide have benefited from QbTest.

The digital tool can significantly reduce the time to diagnosis of ADHD for children and young people – and since being spread across the NHS in England from 2020 it has benefited over 70,000 people, saving the NHS an estimated £38.5 million.

The rapid national rollout of QbTest, developed by innovator Qbtech, is based on a collaboration between the company, Health Innovation East Midlands (HIEM), the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) East Midlands, and the NIHR MindTech HealthTech Research Centre.

The ground-breaking computerised assessment tool measures all three core components of ADHD – attention, impulsivity, and activity. 

In 2013, NIHR ARC East Midlands funded a randomised controlled trial “AQUA-Trial” which was led by Professor Chris Hollis and managed by Dr Charlotte Hall at NIHR MindTech HealthTech Research Centre. The study found that adding QbTest to the standard assessment process made clinicians' ADHD diagnostic decisions 44% faster without any loss of accuracy and increased confidence in their decisions. 

Building on these findings, HIEM piloted the technology across three East Midlands NHS mental health trusts, demonstrating its ability to both reduce diagnosis time and generate significant cost savings by minimising the number of appointments required. 
This laid the foundation for broader adoption by England's 15 Health Innovation Networks (HINs), leading to its rollout from April 2020- March 2023. 

The technology rapidly gained traction and between April 2020 and March 2024 the national impacts included:

• 95,097 hours of healthcare capacity released across the NHS.
• 41,582 clinical appointments saved.
• 71,102 children and young people benefited.
• 79 NHS trusts using the technology, three quarters of all English trusts that provide ADHD services.
• £38.5 million estimated NHS cost savings achieved.

The success of this national rollout has provided Qbtech with a strong basis for global expansion and in October 2024 QbTest reached the milestone of 1 million patients benefiting worldwide.

In addition, an evaluation of the national NHS rollout of QbTest – led by Dr Charlotte Hall from NIHR MindTech HealthTech Research Centre and published by BMC Health Services Research – further evidences the clinical efficiency of the technology.

Nicole McGlennon, Managing Director of Health Innovation East Midlands, said: “We welcome the latest guidance from NICE. This is an example of the fantastic results of close and effective collaboration between research and innovation partners – working together to build an evidence base and then drive the implementation of technologies that transform patient outcomes and generate NHS savings.

"From the initial East Midlands pilot programme across three local NHS trusts, within a couple of years via the 15 Health Innovation Networks we are close to 100 per cent implementation across the NHS in England, benefiting more than 70,000 children and young people and saving valuable NHS resources”.

Professor Chris Hollis, Director of MindTech and Chief Investigator on the AQUA trial said: “I’m delighted that the AQUA trial of QbTest, undertaken by the MindTech HealthTech Research Centre at the University of Nottingham, played a crucial role in supporting NICE’s recommendation for QbTest to be used as an option to help diagnose ADHD in children and young people.  

"The landmark AQUA trial demonstrated that clinicians using QbTest made faster diagnostic decisions when assessing ADHD in children and young people - which could help drive efficiencies and reduce the current long delays to receive an ADHD diagnostic assessment in the NHS.”

Dr Charlotte Hall, Principal Research Fellow, NIHR MindTech said: “It takes a certain amount of confidence and bravery for the industry to open their products up to independent evaluation, particularly when the findings may have huge influence on subsequent sales and revenue. Qbtech were confident in their product and it’s fantastic to see the benefits that can arise from such industry-academic partnerships”.  

Professor Kamlesh Khunti, Director of NIHR ARC East Midlands and Professor of Primary Care, Diabetes and Vascular Medicine at the University of Leicester, said: “QbTest has revolutionised ADHD diagnosis for children and young people by offering an objective assessment tool that measures all three core components.  

"Made possible through the collaboration in the East Midlands, this innovation has significantly reduced the time to diagnosis, providing families with quicker and more accurate assessments. This is a clear example of how partnership-driven innovation can lead to more efficient and effective healthcare solutions.”

Tony Doyle, Managing Director, Qbtech added: This month (October 2024) QbTest achieved the fantastic milestone of one million tests worldwide, and the East Midlands partnership has provided the basis for rapid expansion within and beyond England. It has been a key part of the jigsaw that has enabled us to benefit so many children and young people globally.”  

Key highlights from the NICE guidance include:  

• Robust validation - Effectiveness is supported by data from the AQUA trial (Hollis, Hall, 2018) and other significant papers, ensuring its suitability for faster clinical decision-making, without compromising accuracy. 
• Cost-effective - The QbTest strategy shows an incremental cost-effectiveness ratio of £6,184 per quality-adjusted life year gained. The committee concluded that QbTest was likely to be cost effective when used alongside standard clinical assessment by a healthcare professional to help diagnose ADHD in children and young people. 
• Positive patient experiences - Research highlights the significant impact of QbTest results in enhancing communication for clinicians and understanding of ADHD diagnoses for families and young people. Through increased acceptance, reduced complaints against diagnostic decisions and assessment experience.  
• Detecting subtle clinical data improves equity of care and reduces bias - By detecting subtle clinical data with highly visual outputs, QbTest is especially beneficial for individuals with language or communication difficulties, ensuring an inclusive and accurate assessment process. Healthcare professionals also found QbTest helpful when assessing people with subtle presentation (common in girls and women) and supporting a diagnosis when there were comorbidities. Detecting subtle clinical information in the data and reports. Patient experts also noted that tests may help diagnosis in groups in which symptom masking is prevalent, such as particular ethnic backgrounds and cultures.

Read the full NICE guidance here. For more information visit www.Qbtech.com or visit the Health Innovation East Midlands website for more information about the transforming ADHD diagnosis programme.